Tinnitus Communication Guide

This illustration builds on prior work with patients of Dr. Laurence McKenna and Dr. David Scott, Royal National Throat, Nose and Ear Hospital, London.

Help your patients differentiate between the presence and intrusiveness of tinnitus.

The Tinnitus Communication Guide is designed to help hearing care professionals communicate effectively with their patients. The way you talk about tinnitus can have a powerful impact on your patients and can help them feel hopeful about their future. Conversely, poor communication can make patients feel hopeless by the time they leave their appointment. Thus it is important to make an effort to communicate in a way that comforts and encourages your patients.

Only a portion of patients really struggle with tinnitus and managing its intrusiveness in their lives, and they are the most likely to seek professional help. When they come to you, it is important to let them tell their story and to show empathy.

What follows is a guide filled with tips and tricks to help you communicate effectively and empathetically with your patients.

Start the conversation with open-ended questions

Listening to your patient takes time, but it can ultimately save time. Most people suffering from tinnitus have not had a chance to tell their story. By giving them time and space to talk about their feelings, thoughts, and lifestyle, they feel heard. This can help them work through difficult emotions and feel less alone. You will also find out if they have any negative thoughts about tinnitus. You can change their perspective by sharing information on how they can manage their tinnitus.

Here are some questions you can start with:

  • “Can you tell me about your tinnitus?”
  • “Do you have any concerns about it?”
  • “Are you doing anything differently now because of your tinnitus?”
  • “How do you feel about it?”
  • “Is it affecting other people in your life?”

Show empathy and kindness during the appointment

It is essential that you give your patient space and let them express their emotions. It is also important to demonstrate that you understand your patient's feelings. You can show empathy with comments that assure the patient that you are actively listening:

  • “That sounds very difficult for you.”
  • “How does that make you feel?”
  • “I understand that you want your tinnitus to go away – I would like that too.”

Explain the difference between the presence and intrusiveness of tinnitus

The following graphic can help you explain that there is a difference between how present and loud the sound of tinnitus is and how much distress it causes them.  

Show the graph to your patient. Point on the graph to show that tinnitus may always be present at more or less the same level of sound (sometimes a little lower, sometimes a little louder). The level of distress it causes them and how intrusive it is, however, will likely decrease significantly over time. Almost everyone with tinnitus finds it becomes more manageable and less intrusive over time.

It is very important for your patients to understand this key point. Many patients have been told that their tinnitus, "Will never go away.” This does not mean that the patient will have to struggle with it forever. The goal of this conversation is to give your patient a sense of hope and reduce their fear that they will always feel the same level of distress.

By showing the difference between how present tinnitus is and how intrusive it is, clinicians can foster hope in their patients and help them think about their tinnitus in more constructive ways. Sharing this information with patients early in their treatment can have a huge impact on how they cope with tinnitus in the long term.

The illustration shows the presence of tinnitus (the yellow line), and the level of intrusiveness experienced (the blue line) over time.

You can also show that the sound level may vary over time; sometimes it will be a little louder, sometimes a little quieter, but in general, it will persist. Sometimes your patient will not notice their tinnitus (indicated by the dotted line). You can encourage them to focus on what they were doing at those times, for example if they were busy or distracted.

It is important to explain that this is a forecast based on the experiences of many other people with tinnitus. Neither you nor the patient can foresee what exactly they will experience in the long run. It is unlikely that their tinnitus will go away, but it is probable that it will become less distressing.

Make sure your patient understands the difference between the presence of tinnitus and how intrusive it is

In order to check that your patient understands the difference between the presence and intrusiveness of tinnitus, ask them to show you where they are on the graphic. If the patient points at a point on each of the lines of the graphic, it will indicate that they understand the difference between the loudness and the intrusiveness of the tinnitus.

MYTHS VS. FACTS

Myth: Tinnitus will damage my hearing and make me go deaf

Fact: If you do have hearing loss, you are more likely to experience tinnitus, but tinnitus itself cannot damage your hearing. Tinnitus is often the result of hearing loss, especially in the high pitches.

Myth: Tinnitus is a sign of something serious. The doctors must have missed it.

Fact (If a full medical/audiological work-up has been done): Hearing specialists have checked your hearing and are confident that your tinnitus is not a sign of anything serious. Tinnitus is very common, affecting around 10% of the population, and if your audiological check-up is normal, then this means your tinnitus is not a sign of something serious. 

Myth: Tinnitus will drive me mad.

Fact: Tinnitus can be distressing, particularly when it first starts. It is also worsened by stress. Although this can be difficult to cope with, patients can learn how to manage their tinnitus and live well with it.

Give advice and orientation for concrete next steps

Once patients understand that the way they feel about their tinnitus can improve, they will likely ask what to do to feel better. It may be worth emphasizing that for many people, the intrusiveness will go away on its own. This is called habituation. However, there are things that people can do to support the natural habituation process, such as managing stress and taking care of themselves. Patients can also find help on relevant websites, from the First Aid Kit, or by watching videos with testimonials from other patients who have learned to manage their tinnitus.

Some patients may benefit from wearing hearing aids or using masking devices such as sound generators or smartphone apps that stream sounds or music into hearing aids. Other patients might benefit from participating in group sessions to share their experiences with fellow tinnitus sufferers. Others still might benefit from meeting with mental health professionals who can help them with relaxation techniques, changing their thoughts on tinnitus, and learning to cope and live well with tinnitus. Some might learn how to divert attention away from their tinnitus. There are many options and it is important that you help each patient find what works best in their individual case.

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